{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T03:12:17Z","timestamp":1780542737872,"version":"3.54.1"},"reference-count":52,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,9,3]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Adults with congenital heart disease (CHD) are at increased risk of stroke but high\u2010quality population level data on stroke incidence in these patients are scant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      A retrospective whole\u2010population Western Australian cohort of adult\u00a0patients with CHD aged 18 to 64\u2009years was created and followed from January 2000 to December 2017 using linked hospital data. Stroke incidence rates within the adult cohort with CHD were calculated and compared with the general population via direct standardization. A nested case\u2013control design assessed predictors of ischemic and hemorrhagic stroke within the cohort. Among 7916 adults with CHD, 249 (3.1%) incident strokes occurred at a median age of 47\u2009years; 186 (2.3%) ischemic, 33 (0.4%) hemorrhagic and 30 (0.4%) unspecified strokes. Ischemic and hemorrhagic stroke incidence was, respectively, 9 and 3 times higher in adults with CHD than the general population. Absolute risk was low with annual rates of 0.26% (ischemic) and 0.05% (hemorrhagic). Highest rates were observed in adults with shunt and left\u2010sided lesions. Predictors of ischemic stroke in adults with CHD included recent cardiac surgery, left\u2010sided valve repair\/replacements, shunt lesions, and traditional risk factors (hypertension, infective endocarditis, peripheral vascular disease, and tobacco use). Mental health disorders and increasing Charlson's comorbidity scores were strongly associated with higher risk of ischemic and hemorrhagic stroke. The CHA\n                      <jats:sub>2<\/jats:sub>\n                      DS\n                      <jats:sub>2<\/jats:sub>\n                      VASc score was associated with ischemic stroke incidence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">This study provides the first population\u2010based stroke incidence estimates for adults with CHD in Australia, showing elevated stroke risk across different CHD lesions. It highlights the potential clinical importance of managing comorbidities, especially mental health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.123.034057","type":"journal-article","created":{"date-parts":[[2024,8,27]],"date-time":"2024-08-27T12:38:41Z","timestamp":1724762321000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Incidence and Predictors of Stroke in Australian Adults With Congenital Heart Disease (2000\u20132017)"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3406-6019","authenticated-orcid":false,"given":"Nita","family":"Sodhi\u2010Berry","sequence":"first","affiliation":[{"name":"The University of Western Australia","place":["Crawley, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9786-1840","authenticated-orcid":false,"given":"Luke J.","family":"Burchill","sequence":"additional","affiliation":[{"name":"Mayo Clinic College of Medicine","place":["Rochester, USA"]},{"name":"University of Melbourne","place":["Parkville, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4430-3276","authenticated-orcid":false,"given":"Timothy J.","family":"Kleinig","sequence":"additional","affiliation":[{"name":"Royal Adelaide Hospital","place":["Adelaide, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3970-625X","authenticated-orcid":false,"given":"Lee","family":"Nedkoff","sequence":"additional","affiliation":[{"name":"The University of Western Australia","place":["Crawley, Australia"]},{"name":"Victor Chang Cardiac Research Institute","place":["Sydney, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5287-5819","authenticated-orcid":false,"given":"Judith M.","family":"Katzenellenbogen","sequence":"additional","affiliation":[{"name":"The University of Western Australia","place":["Crawley, Australia"]},{"name":"The University of Western Australia","place":["Perth, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2018.10.015"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2012.07.023"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.012030"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2019.00329"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1586\/14779072.2016.1133294"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-022-00749-y"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.016400"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.116.012882"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.116.003257"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.119.024156"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.21037\/cdt-20-631"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2010.196147"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.115.003071"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.011241"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2017-311620"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.020939"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.020032"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(21)00252-0"},{"key":"e_1_3_2_20_2","volume-title":"Australian Demographic Statistics, Cat no. 3101.0","author":"Australian Bureau of Statistics","year":"2017","unstructured":"Australian Bureau of Statistics . 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